Postoperative complications after surgery for typhoid ileal perforation in adults in Kumasi

Abstract

Background: The surgical complications of typhoid ileitis such as ileal perforations (TIP) continue to cause many deaths especially in countries with poor sanitation and limited health care facilities. Objective: To assess and highlight the complications associated with typhoid ileal perforation. Methods: A prospective study of the postoperative complications after closure of TIP was conducted between Jan. 2002 and Dec. 2005 at the Komfo Anokye Teaching Hospital (KATH.) Results: A total of 248 patients aged between 16 and 54 years with a mean age of 24.9 (8.3) and a median of 23.5 years were operated upon for TIP. There were 180 males (72.6%) and 68 females (27.4%) with a male to female ratio of 4: 1. The diagnosis of TIP was based on clinical, radiological and operative findings. The over all complication rate was 49.3%. The most common postoperative complication was wound infection (52A %). The most serious were persistent peritonitis (34.7 %) and enterocutaneous fistula (10.0%) with a mortality of 33.3 % and 22.2 % respectively. The overall mortality was 10.9%. These complications significantly increased the duration of hospital stay of survivors by several days (p<0.01) Conclusion: Very serious complications occur after surgery for TIP in adults. These complications may contribute to the high mortality from this disease.